Pharmacology Diuretics 2

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Pharmacology Diuretics 2
2013-11-24 21:52:47
Pharmacology Diuretics

Pharmacology Diuretics 2
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  1. What are the therapeutic uses of Thiazide diuretics?
    Hypertension, Edema, Diabetes Insipidus, Decrease Ca excretion to decrease kidney stones
  2. Can Loop diuretics be used to prevent kidney stones, why?
    No, opposite, cause Ca excretion increasing chance of Kidney Stones
  3. What are the adverse effects of Thiazide diuretics?
    Hypokalemia, ↑ plasma glucose, urate and lipids
  4. Can Thiazide diuretics be used during pregnancy?
  5. Thiazide diuretics increased the risk of toxicity from what other drugs?
    Digoxin and Lithium
  6. The Na/Cl transporter that is blocked by Thiazide diuretics is located on the urine or blood side of the tubule?
  7. What is another term for Loop Diuretics?
    High Ceiling Diuretics
  8. What is the most frequently prescribed Loop diuretic?
  9. What is the MOA for furosemide?
    Blocks Na/K/2Cl co transporter in thick segmented ascending limb of Henle’s loop
  10. Which diuretic group dissipates the medullary interstitial gradient?
    Loop diuretics
  11. Do Loop diuretics like Furosemide cause diuresis?
    Yes, high Diuresis
  12. What routes of administration are available for Furosemide?
    PO, IV, IM
  13. PO Furosemide has what OOA and DOA?
    OOA: 60 minutes and DOA: 8 hours
  14. IV Furosemide has what OOA and DOA?
    OOA: 5 minutes and DOA: 2 hours
  15. By what route is Furosemide eliminated?
    Hepatic metabolism
  16. When is Furosemide used?
    For rapid massive fluid removal (Pulmonary Edema of cardiac, hepatic or renal origin), hypertension that did not respond to other diuretics
  17. Does Furosemide work when renal blood flow/glomerular filtration are low?
  18. If renal blood flow is low, would you use a thiazide or loop diuretic if renal blood flow is low?
    Loop diuretic (still works when flow is low, unlike thiazide)
  19. What are the adverse effects of Loop diuretics?
    Hyponatremia, hypochloremia which both cause dehydration and hypotension
  20. Do you loose more solute than water or water than solute with Loop Diuretics?
    Solute than water
  21. Do Loop diuretics increase risk of gout?
  22. Should Loop diuretics be used during pregnancy, why?
    No, cross the placenta
  23. What DDIs does Furosemide have?
    Digoxin, Other Ototoxic drugs (gentamycin)
  24. Why is digoxin contraindicated with Loop diuretics?
    Increased Risk of Digoxin toxicity due to low potassium caused by the diuretic
  25. Why are ototoxic drugs contraindicated with Loop Diuretics?
    Loop Diuretics can be Ototoxic, so adding another ototoxic drug can enhance this issue
  26. What type of diuretic would you select for a person who is allergic to sulfa drugs?
    Loop diuretic
  27. What are the Loop Diuretics?
    Furosemide, Ethacrynic acid, Bumetanide, Torsemide
  28. What is the trade name for Mannitol?
  29. What are the osmotic diuretics?
    Mannitol, Urea, Glycerin and Isosorbide
  30. What is the MOA of Mannitol?
    Pulls water out of cells and carries it through tubules limiting reabsorption, causing excreting of body water in excess of electrolytes
  31. What is Mannitol?
    Non-metabolized 6 carbon sugar, freely filtered with minimal reabsorption
  32. By what route is Mannitol given?
  33. (True/False) Small amounts of Mannitol can cause a large effect.
    False, need large quantities to change the plasma osmolality
  34. What is a normal dose of Mannitol?
    50-200 grams over 24 hours
  35. What is the OOA and DOA for Mannitol?
    OOA: 30-60 minutes DOA: 6-8 hours
  36. What are the adverse effects of Mannitol?
    Removes cellular water which may exacerbate heart issues, HA, N and V, Fluid and Electrolyte imbalances
  37. What are the therapeutic uses of Mannitol?
    Prophylaxis of renal failure, reduction in intracranial and intraocular pressure
  38. When would you use Mannitol for Glaucoma?
    When patient does not respond to other treatments
  39. Why is Mannitol useful for Renal failure prophylaxis?
    Keeps fluid in the tubules to keep them from collapsing
  40. How do Vaptans work?
    Antagonize ADH receptors (V2 and/or V1) by preventing ADH insertion of aquaporins reducing H20 reabsorption in the collecting duct
  41. What is the physiological effect of Vaptans?
    Selectively facilitates H20 secretion
  42. What is the dosage form available for Conivaptan?
  43. What is the trade name for Conivaptan?
  44. What is Conivaptan (Vaprisol) used to treat?
    Hyponatremia due to Inappropriate ADH secretion and Hypervolemic hyponatremia or CHF
  45. Are Vaptans well tolerated?
  46. Vaptans cause in increase in body Na concentration (True/False)
  47. What effect do Vaptans have on Plasma volume and urine osmolality?
    Reduce plasma volume and decrease urine osmolality